Provider Demographics
NPI:1104003276
Name:ELCHAMI, WALEED BEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:WALEED
Middle Name:BEN
Last Name:ELCHAMI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 MADISON AVE
Mailing Address - Street 2:STE 1800
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1110
Mailing Address - Country:US
Mailing Address - Phone:212-868-9321
Mailing Address - Fax:646-335-0450
Practice Address - Street 1:425 MADISON AVE
Practice Address - Street 2:STE 1800
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1110
Practice Address - Country:US
Practice Address - Phone:212-868-9321
Practice Address - Fax:646-335-0450
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055999122300000X
NJ22DI02302000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist